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. 2021 Mar 10;20(1):74.
doi: 10.1186/s12939-021-01410-9.

Experiences of everyday racism in Toronto's health care system: a concept mapping study

Deb Finn Mahabir  1 , Patricia O'Campo  2 , Aisha Lofters  3 , Ketan Shankardass  4 , Christina Salmon  5 , Carles Muntaner  6   7
Affiliations

Experiences of everyday racism in Toronto's health care system: a concept mapping study

Deb Finn Mahabir et al. Int J Equity Health. .

Abstract

Background: In Canada, there is longstanding evidence of health inequities for racialized groups. The purpose of this study is to understand the effect of current health care policies and practices on racial/ethnic groups and in particular racialized groups at the level of the individual in Toronto's health care system.

Methods: This study used a semi-qualitative study design: concept mapping. A purposive sampling strategy was used to recruit participants. Health care users and health care providers from Toronto and the Greater Toronto Area participated in all four concept mapping activities. The sample sizes varied according to the activity. For the rating activity, 41 racialized health care users, 23 non-racialized health care users and 11 health care providers completed this activity. The data analysis was completed using the concept systems software.

Results: Participants generated 35 unique statements of ways in which patients feel disrespect or mistreatment when receiving health care. These statements were grouped into five clusters: 'Racial/ethnic and class discrimination', 'Dehumanizing the patient', 'Negligent communication', 'Professional misconduct', and 'Unequal access to health and health services'. Two distinct conceptual regions were identified: 'Viewed as inferior' and 'Unequal medical access'. From the rating activity, racialized health care users reported 'race'/ethnic based discrimination or everyday racism as largely contributing to the challenges experienced when receiving health care; statements rated high for action/change include 'when the health care provider does not complete a proper assessment', 'when the patient's symptoms are ignored or not taken seriously', 'and 'when the health care provider belittles or talks down to the patient'.

Conclusions: Our study identifies how racialized health care users experience everyday racism when receiving health care and this is important to consider in the development of future research and interventions aimed at addressing institutional racism in the health care setting. To support the elimination of institutional racism, anti-racist policies are needed to move beyond cultural competence polices and towards addressing the centrality of unequal power social relations and everyday racism in the health care system.

Keywords: Concept mapping; Everyday racism; Health care; Institutional racism; Policy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Cluster map with the major conceptual regions of the collective experiences of disrespect or mistreatment in Toronto’s health care system
Fig. 2
Fig. 2
Pattern match comparison between action/change and ‘race’/ethnic based discrimination as rated by racialized health care users in Toronto’s health care system
See this image and copyright information in PMC

References

    1. Public Health Agency of Canada . Key health inequalities in Canada: a national portrait. Pan-Canadian Health Inequalities Reporting Initiative. 2018.
    1. Ramraj C, Shahidi FV, Darity W, Jr, Kawachi I, Zuberi D, Siddiqi A. Equally inequitable? A cross-national comparative study of racial health inequalities in the United States and Canada. Soc Sci Med. 2016;161:19–26. doi: 10.1016/j.socscimed.2016.05.028. - DOI - PubMed
    1. Siddiqi A, Shahidi FV, Ramraj C, Williams DR. Associations between race, discrimination and risk for chronic disease in a population-based sample from Canada. Soc Sci Med. 2017;194:135–141. doi: 10.1016/j.socscimed.2017.10.009. - DOI - PubMed
    1. Siddiqi AA, Wang S, Quinn K, Nguyen QC, Christy AD. Racial disparities in access to care under conditions of universal coverage. Am J Prev Med. 2016;50(2):220–225. doi: 10.1016/j.amepre.2014.08.004. - DOI - PubMed
    1. Veenstra G, Patterson AC. Black–white health inequalities in Canada. J Immigr Minor Health. 2016;18(1):51–57. doi: 10.1007/s10903-014-0140-6. - DOI - PubMed